Retiree solutions and Medicare group plans

Employers who provide health insurance coverage for their retirees need three things:

Health plans with doctors located where retirees live.

Coverage that gives their retirees assurance that they will be well-cared for in their golden years.

Affordable options that won’t impede the bottom line.

Group coverage options

At Fallon Health, we offer complete solutions for your retirees. Fallon Senior Plan™ Premier HMO is our Medicare Advantage Plan that offers a statewide network of providers. Members have access to doctors and hospitals everywhere from the South Coast to the North Shore and from western Massachusetts to Boston. For those looking for even more flexibility, we offer Fallon Companion Care—with no deductibles or referrals, plus access to providers across the U.S.

Plan choices

Fallon Senior Plan Premier HMO

Fallon Companion Care

Fallon Senior Plan Premier HMO

Overview

For retirees who live in Massachusetts and select neighboring cities and towns, we offer Fallon Senior Plan Premier HMO. The Fallon Senior Plan Premier HMO network is statewide and includes some of the best local providers, including:

Eligibility

Be eligible for a Medicare group plan through an employer or a union health and wellness organization

Be enrolled in Medicare Part A and Part B

Continue to pay their Medicare Part B premium or have it paid for by another source

Reside within the approved service area.

Service area

To be eligible for Fallon Senior Plan Premier HMO, retirees must live in the service area. The Fallon Senior Plan Premier HMO service area includes the Massachusetts counties of Barnstable, Berkshire, Bristol, Essex, Franklin, Hampden, Hampshire, Middlesex, Norfolk, Plymouth, Suffolk and Worcester, as well as some cities and towns that neighbor Massachusetts (shown in green, yellow, brown and blue on the map).

Fallon Companion Care

Overview

Fallon Companion Care is our coast-to-coast health care coverage solution for Medicare-eligible retirees, whether they live in Wellfleet or West Palm Beach.

Like Fallon Senior Plan Premier HMO, Fallon Companion Care offers more than Original Medicare alone. And, since Fallon Companion Care doesn’t have a provider network, retirees can choose any provider who accepts Medicare and is most convenient for them.

Fallon Companion Care acts as a secondary payer for Medicare-approved services, and covers costs not paid by Medicare for services such as:

Doctor office visits

Tests and screenings, including X-rays and labs

Hospital admissions

Durable medical equipment, including wheelchairs and oxygen

Emergency care inside and outside the U.S.

Fallon Companion care plan options include those with and without prescription drug coverage.

Fallon Companion Care also includes the It Fits! benefit—a $200 annual fitness reimbursement that members can use for anything from gym memberships at the gym of their choice to yoga classes to ski lift tickets.

Eligibility

To be eligible for Fallon Companion Care, members must:

Be eligible for a Medicare group plan through an employer or a union health and wellness organization

Be enrolled in Medicare Part A and Part B

Continue to pay their Medicare Part B premium or have it paid for by another source.

Service area

Fallon Companion Care is available to retirees who live in the United States.

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